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March 2021

Blue Cross and BCN Pharmacy to cover additional childhood vaccines, starting March 1

To increase access to childhood vaccines and decrease the risk of vaccine‑preventable disease outbreaks among children, Blue Cross Blue Shield of Michigan and Blue Care Network Pharmacy Services is adding the following vaccines to its list of covered vaccines, starting March 1, 2021:

Vaccine Common name Age requirement
ActHIB® Haemophilus influenzae type B None
Hiberix® Haemophilus influenzae type B None
PedvaxHIB® Haemophilus influenzae type B None
ProQuad® Measles, mumps, rubella and varicella None
Rotarix® Rotavirus None
RotaTeq® Rotavirus None
Vaxelis™ Tdap, inactivated poliovirus, haemophilus B, hepatitis B None
Pediarix® Tdap, hepatitis B, polio None
Kinrix® Tdap, polio None
Quadracel® Tdap-IPV Tdap, polio None
Pentacel® Tdap, polio, haemophilus influenzae type B None
Diptheria and tetanus toxoids Tetanus, diphtheria None

The following lists all the vaccines currently covered under eligible members’ prescription drug plans. Most Blue Cross commercial, non‑Medicare members with prescription drug coverage are eligible. If a member meets the coverage criteria, we cover the vaccine with no cost share.

Vaccine Common name Age requirement
Influenza virus Flu

Under 9 years old:
2 vaccines per 180 days

9 years and older:
1 vaccine per 180 days
ActHIB® Haemophilus influenzae type B None
Hiberix® Haemophilus influenzae type B None
PedvaxHIB® Haemophilus influenzae type B None
Havrix® Hepatitis A None
Vaqta® Hepatitis A None
Energix‑B® Hepatitis B None
Heplisav‑B® Hepatitis B None
Recombivax HB® Hepatitis B None
Twinrix® Hepatitis A & B None
Gardasil®9 HPV (Human papillomavirus) 9 to 45 years old
M‑M‑R® II Measles, mumps, rubella None
ProQuad® Measles, mumps, rubella and varicella None
Menveo® Meningitis None
Menactra® Meningitis None
Menomune® Meningitis None
Trumenba® Meningococcal B None
Bexsero® Meningococcal B None
Ipol® Polio None
Pneumovax 23 Pneumonia None
Prevnar 13® Pneumonia 65 and older
Rotarix® Rotavirus None
RotaTeq® Rotavirus None
Shingrix® Shingle (Zoster) 50 and older
Boostrix® Tdap (Tetanus, diphtheria and whooping cough, also known as pertussis) None
Adacel® Tdap None
Vaxelis™ Tdap, inactivated poliovirus, haemophilus B, hepatitis B None
Pediarix® Tdap, hepatitis B, polio None
Kinrix® Tdap, polio None
Quadracel® Tdap‑IPV Tdap, polio None
Pentacel® Tdap, polio, haemophilus influenzae type B None
Diptheria and Tetanus Toxoids Tetanus, diphtheria None
Tenivac® Tetanus, diphtheria None
TDVax® Tetanus, diphtheria None
Varivax® Varicella (chickenpox) None

If a member doesn’t meet the age requirement for a vaccine, Blue Cross won’t cover the vaccine under the prescription drug plan and the claim will reject.

Certified, trained, qualified registered pharmacists must administer vaccines.

No portion of this publication may be copied without the express written permission of Blue Cross Blue Shield of Michigan, except that BCBSM participating health care providers may make copies for their personal use. In no event may any portion of this publication be copied or reprinted and used for commercial purposes by any party other than BCBSM.

*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2020 American Medical Association. All rights reserved.
Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and
independent licensees of the Blue Cross and Blue Shield Association.